Momentum Builds to Confront Child Obesity

Legislative momentum continues to build at the federal and state levels to tackle childhood obesity.

Last week, a Senate hearing was held to discuss the proposed Childhood Obesity Reduction Act, which would establish a congressional council on childhood obesity to help schools craft better nutritional policies. The $2.2 million bill would also set up an independent foundation to award obesity-prevention grants to schools and other organizations.

Just a week earlier, the Washington-based National Academies’ Institute of Medicine released a report concluding that ending childhood obesity would require a long-term commitment by the federal government, schools, communities, and state and local policymakers.

That same week, Sen. Edward M. Kennedy, D-Mass., introduced a bill, the Prevention of Childhood Obesity Act, which would establish a federal leadership commission that would set prevention goals and make recommendations on federal policies and programs.

At the state level, meanwhile, several states have taken action to confront the problem, such as passing new nutritional requirements for vending-machine food in schools or introducing legislation to ban the sale of vending-machine food during school hours.

Advocates are hoping the impetus of the Institute of Medicine report serves as a rallying cry for federal and state lawmakers.

“The value of [the] report is that it’s coming out and talking about immediate action at all these levels of involvement, and that’s how we’ll combat childhood obesity, because one component can’t do it alone,” said Dr. Mary L. Gavin, a pediatrician at Dupont Hospital for Children in Wilmington, Del.

‘Changing Public Perception’

The Institute of Medicine report recommends that schools at all levels institute new nutritional standards, increase their emphasis on physical education, and revise school curricula to promote healthy eating.

It also recommends that doctors measure a child’s body-mass index annually, a somewhat controversial suggestion, according to some experts, because of the potential for embarrassing children or unfairly labeling them as obese.

Arkansas schools, for instance, began calculating the body-mass index of all students in grades K-12 last school year. The results of those calculations were released last month, and found that nearly 40 percent of students in the state are overweight or at risk of being overweight, which is slightly high er than the national average. ("Arkansas Pupils' Body Weight Adds Up," Sept. 15, 2004.

The Institute of Medicine report also calls on state and local governments to establish zoning requirements that encourage the construction of more sidewalks, bike paths, and recreational areas.

In addition, the report observes that parents are not aware of the potential health hazards associated with obesity. As a consequence, it calls for aggressive efforts to educate parents on the basics of a healthy diet.

The food and beverage industry, the report suggests, should implement marketing guidelines that would limit the advertising of junk foods to children. However, those guidelines would be voluntary.

Dr. Dixie Snider, the acting chief of science at the Centers for Disease Control and Prevention who appeared before the Senate committee hearing on childhood obesity last week, told the legislators that 60 percent of overweight children run the risk of developing cardiovascular disease later in life, and that Type 2 diabetes, which was very rare among children and adolescents a decade ago, is growing at a disturbing rate.

Still, while most experts support the report’s recommendations, some warn that the fight against obesity—much like smoking—will be a long, drawn-out battle that could take decades to win. The report’s recommendations, they say, are not quick fixes and will take some things schools and government agencies are often in short supply of—resources and money.

Dr. William J. Klish, a pediatric gastroenterologist with Texas Children’s Hospital in Houston, said it will take a long time for some of the recommendations to be implemented “because of the cost and difficulty [involved in] changing public perception and attitude.”

State Efforts

Several states have already joined the fight against obesity.

California was among the first to attempt to change public attitudes when it approved a bill last year that prohibits the sale of sodas in schools statewide. Ark ansas followed suit in the same year by banning student access to vending machines in elementary schools.

Since then, vending machines have been one of the primary—and sensitive—topics in the debate on childhood obesity. Industry advocates have fought many measures, arguing that vending-machine foods, when eaten in moderation, are not unhealthy, and that to truly battle obesity, children need to eat properly and exercise in and out of school.

In addition to California and Arkansas, four states—Colorado, Louisiana, Tennessee, and Washington—have passed laws that either restrict vending-machine sales or encourage their schools to investigate how they can supply more nutritional food items.

Bills to ban the sale of unhealthy foods in school vending machines have been introduced in Kentucky, Maryland, New Jersey, and Oklahoma.

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